Last of us jokes aside, how correct is the claim that fungis do not pose a strategic threat to mankind or human civilization because humans used to live in much unhealthier conditions and if a fungi could have wiped us out, it would already have? This is why I'm not too concerned about pandemics. We used to be cave dwellers, to live alongside animals. Nature had plenty of opportunities to wipe us out when we were at our weakest, and it failed.
Unless a novel disease emerges or is manufactured that totally outclasses everything nature came up with in earth's history, we're going to be fine.
Hard for things to spread when you're small groups of people without interaction with anyone outside your group. And yes small groups of people were routinely completely wiped out.
> Nature had plenty of opportunities to wipe us out when we were at our weakest, and it failed.
But that wasn't when we were at our weakest, not necessarily. Diseases need to spread. When we lived in scattered hunter gatherer groups it was really tough for diseases to spread, and if they couldn't spread, it was difficult for them to persist in a population and evolve. Now the spreading is easy. Furthermore, spreading is easier among certain animal populations because we raise them packed into warehouses and we ship them around the world via truck, train, boat, and plane.
The world is a very different place, so using the past as a model to predict the future is dicey.
But long after the taming of horses, the invention of roadways and carts, and the proliferation of dense urban areas.
"International" trade has surely always existed - we know people far from the sea decorated their bodies with cowrie shells in prehistoric ages. But the scale of contact and interaction has not remained constant.
Arguably, the Middle Ages is when Eurasian society was at its weakest WRT disease.
The Plague of Justinian (the first major instance of the disease) in the 6th Century wiped out at least 40% of the population of Constantinople--the largest and most advanced city in Europe at the time.
It's estimated it wiped out 25-60% of the population of Europe over the course of 2 centuries (15-100 million people).
I know, and that's my point. Global transportation isn't a new thing. Nature had a window of opportunity of about one thousand years or two to deal with us and we're still here and kicking.
If you're genuinely interested, you'd be better off getting up to speed on the current research instead of putting forth extremely rudimentary theories.
There are two factors now which make things different:
1. As other commenters have pointed out, the ease of spread of any disease is orders of magnitude higher now than it was during cave-man days. With crowded cities, public transit, and air travel, pandemic-level diseases can spread across the world in a matter of days or weeks.
2. Much more importantly, our use of medicines (antibiotics, antivirals, antifungals, etc.) have put extreme selective pressure on pathogens to evolve to become resistant to them. We are, in a sense, selectively breeding pathogens that are both good at infecting humans and resistant to our treatments. That is a focused selective pressure that has never existed before, and may pose the biggest threat to us in the next 50-100 years. For a concrete example, look at this experiment which shows how quickly bacteria can evolve to overcome levels of antibiotics that are orders of magnitude more than we would ever give a human [0].
Yes, there will generally always be some subset of the human population that is resistant to any particular disease, but our measure of success is not "5% of humans will survive the next pandemic, so we're all good, let's it move along nothing to see here." If we start to regularly have drug-resistant pathogens that make hospital stays very dangerous for patients (imagine having a 1/3 or even 1/10 chance of dying at a hospital due to an infection entirely irrelevant to your condition) or just more common COVID-level pandemics, that would be a serious disruption to humanity, significantly increase general mortality rates across the board, and drastically change life as we know it.
> Much more importantly, our use of medicines (antibiotics, antivirals, antifungals, etc.) have put extreme selective pressure on pathogens to evolve to become resistant to them.
I don't think that makes sense when comparing against the threat level of pre-antimicrobial times. It didn't matter that they weren't resistant before we had antimicrobial drugs. Lack of resistence was useless in cave man times.
I’m upset you’re quick to blame density and public transit but won’t even mention the risk of animal meat consumption, which is responsible for what, all the pandemics we’ve had?
Nobody said anything veganism nor moralism except for you. (Almost?) all pandemics were zoonotic. We have reduced the amount of species we keep in our cities but we still have meat markets where they are kept alive until they’re butchered for freshness. Like in Wuhan.
> As we increase our interactions with animals through hunting, the trading of animal foods, animal husbandry practices, wet markets, and the domestication of animals or exotic pets, the probability of cross-species transmission dramatically increases.
My list was not meant to be comprehensive, but that's what I meant by "our use of medicines (antibiotics, antivirals, antifungals, etc.)." That includes heavy antibiotic use in farming which also likely contributes to antibiotic resistance.
Surprised no one has already mentioned climate change.
The truly terrifying thing is that the reason fungi have not been a big threat to humans is that there was not evolutionary pressure for them to thrive in human body temperatures.
Now, due to the warming climate there is immense pressure. As fungi evolve to adapt to the warming climate, they are evolving to be able to infect and kill us.
Yes, climate change is the culprit for all ills, or at least that's what you read everywhere ;)
Climate change was mentioned on "The Last of Us" episode 1, at the start. Aside from fictional references, there are fungi that can grow outside of 70-90F up to 130-150F. I believe COVID and people rushing to the hospital emergency room for everything instead of going to their PMC may have had something to do with this fungus finding purchase to infect more people.
<< it may be the first example of a new fungal disease emerging from climate change, with the caveat that many other factors may have contributed.>>
Significant or not? <<many other factors may have contributed>>
<<The most enigmatic aspect of the rise of Candida auris as a human pathogen is that it emerged simultaneously on three continents, >>
I would be interested to know if COVID happened everywhere around the same time relatively speaking, with people self-quarantining while all running to the emergency room of hospitals, might explain the "enigma" above.
Yeah, that paper is trash. There's zero evidence provided. In fact, they literally suggest that somebody else should find evidence to support their conclusion:
> The hypothesis that C. auris broke the mammalian thermal barrier through adaptation to climate change suggests several experimental lines of investigation to obtain evidence for and against it.
Nonetheless, they still cite to earlier papers (multiple!) of theirs to argue that they "predicted" their current speculative conclusion; for example,
> Given the capacity of fungal species to adapt to higher temperatures and the fact that many fungal species that are currently nonpathogenic species are likely to have the necessary virulence attributes by virtue of their survival in soils, we previously hypothesized that climate change would bring new fungal diseases
And in case anybody missed it (as I did, initially), the entirebody of this "paper" is under the header, "OPINION/HYPOTHESIS".
Because that’s ridiculous and literally the plot of the Last of Us. There are fungi that live in the human body already. What do you think a yeast infection is?
Any source besides "climate change bad"? Plenty of areas have hovered around 98 degrees Fahrenheit for at least some part of the year for a very long time, I haven't seen any correlation between those areas and fungal outbreaks, or even any data that says the global sum person-time in areas that are around 98 degrees is going up.
Isn't the new schtick "global climate change", where extreme temperatures are more common? Seems like that'd be an argument against climate change favoring this fungus thing.
It's complicated. There is warming occurring, on average, overall, that's indisputable at this point. Variation is also increasing. (Or to restate it... things have gotten spiky...the average is trending up, but the increase in variation is such that the lowest lows are lower than they were in the past.
How would this happen? can you give an example? are you saying the climate is getting closer or passing through our body temperature range and so they want to jump in to our regulated bodies?
I think this premise is false and misunderstands how Evolution works. Evolution works by opportunity, not by pressure. Organisms do not choose to evolve because their habitat is degraded. They don't "try harder" under pressure. The opportunity to infect humans has always existed for a suitable mutation. Climate change does not make advantageous mutation more likely to happen.
> Unless a novel disease emerges or is manufactured that totally outclasses everything nature came up with in earth's history
What makes you think this is unlikely? Even putting aside that bioengineering is a very real thing, there is historical precedent for terrible novel diseases (e.g. black death, Spanish flu).
I'll also point out that "humanity is totally wiped out" and "we're going to be fine" are not exhaustive. A disease killing 10% of the world's population would not be fine.
> Candida auris is a drug-resistant fungus that can cause outbreaks in health care facilities, according to the CDC.
> The fungus can infect the bloodstream and even cause death by invading the blood, heart and brain, the agency said. More than 1 in 3 patients die from such an infection.
Only focused on the ineffectiveness of drugs to treat it. One has to feed yeast with sugars to keep it alive. Not giving medical advice here, just pointing out practitioners of disciplines other than allopathy have solutions for candida infection.
No one is successfully treating candida with homeopathy and using the derogatory term "allopathy" for conventional medicine isn't really appropriate here.
Except for, you know, the entire field of functional medicine which has done wonders for the lives of millions who have been failed by the mainstream medical establishment.
What's your standard of evidence? The functional medicine folks I follow and who I am a client of generally follow the latest research closely. In the content they produce and in the books they write, they refer to and cite hundreds of studies.
I was hoping for critiques of specific functional medicine treatments that were administered, but didn't find many in the article. Their link about heavy metal poisoning being "rejected by medical science" is a broken link.
Besides that the article is mostly just attempted character assassination of various people and goes after some of the more fringe elements / treatments in the field.
A huge part of functional medicine is just helping the patient address lifestyle factors - diet, exercise, sleep, stress, and removing negative environmental influences, whether those are a person, a diet issue (particular foods can do a lot of damage), a physical environmental issue such as mold, etc.
The first step that every (decent) functional medicine doctor takes with a new patient is just looking for nutritional deficiencies and other lifestyle factors, and doing tests and asking questions to check for those things. Completely uncontroversial and backed up by science that everyone on earth agrees with. But regular doctors don't even take that basic step for their patients because it takes too long to actually learn about a person, their background, their personality, etc. and actually help them create lifestyle change.
Beyond that, I wish the critics would actually address the more common treatments in functional medicine instead of the fringe stuff. Things like alternative treatments for parasites (blastocystis, various worms, dientamoeba, etc.), candida overgrowth, SIBO, heavy metal poisoning, various autoimmune issues, nutritional deficiencies, hormonal issues, etc.
The modern healthcare system is broken in a hundred ways but instead of having any curiosity about alternative approaches folks like the author of this article just attack the field and the people in it rabidly.
As the other commenter pointed out, functional medicine has no backing in evidence. As an anecdote a functional "doctor" recently told my mother-in-law to have all of her fillings removed to treat a thyroid problem, which is obviously nonsense.
True... but the discipline of homeopathy is stuck in 1832. Despite the advances in evidence-based medicine from the back half of the 19th century through today, to homeopaths and other quacks no progress has been made since the days of bloodletting and mercury tinctures, it's all dangerous "allopathy".
This is standard gish-gallop. You're wrong on the facts and deflecting by bringing up a tangential topic. Only homeopath charlatans use the word allopathy and they invented it.
You can use it all you want, but it's still a term invented to slander real medicine by people who are basically snake oil salesmen. You may as well just use the term medicine, which is the conventional name for modern evidence-based medicine. I would point you to the wikipedia article for the term [1]. The only people who seem to use it anymore are alternative "medicine" folks.
A. The pandemic created a lot more chronically ill people. This is a condition typically associated with people who are already seriously unwell.
B. Antibiotic resistance is associated with certain metabolic states, such as excess acidity. Some studies suggest it is reversible if you address this, yet this seems to not be standard practice.
C. I wonder if anyone has tried salt as a treatment. (Probably not.)
Lots of natural anti-fungal treatments we don't use. Garlic oil is one for example. The problem comes when you have to ensure the facility is clean after an outbreak. Hard to get rid off the infection.
> The pandemic created a lot more chronically ill people. This is a condition typically associated with people who are already seriously unwell.
You're making a huge leap.
The magnitude of "unwell" here is critical. This particular infection has been killing people who are at end of life -- people in nursing homes, hospice, etc. Maybe the pandemic created more of these people, but it's not the same thing as "long covid" (if that even has a definition).
Folks with these sorts of ME/CFS/Long Covid constellations of symptoms are simply not in the same class as elderly people in nursing homes.
It often attacks people with respiratory issues who need invasive devices to treat their lung issues.
A lot of people got such treatment for covid.
Edit:
To the coward who made a drive by swipe at me then deleted it before I could hit reply:
Look, I'm not the one putting out info that this infection has spread dramatically. The CDC is.
I'm wondering what some of the mechanisms are for spreading it.
We likely don't know what the tipping point is for something like this. You treat enough school kids for parasitic worms in a developing country and general incidence goes down for the entire neighborhood surrounding the school.
> It often attacks people with respiratory issues who need invasive devices to treat their lung issues. A lot of people got such treatment for covid.
First, it doesn't "often" attack anyone -- there have only been several thousand cases, total.
Second, you can't bundle together "was on a ventilator at some point" with "is currently on a vent and in a hospital". Very different, and again, the latter is where this fungus is being seen. People in hospitals, having serious full-time care. These are not "lung issues", they're acute, near-death interventions.
Third, people in the ICU on a vent are at serious risk for everything -- a rare fungus is far down the list, below things like strep, H. inf., S. aureus, E. coli, etc., which are ubiquitous, and all over your body, right now. If you're not worried about those, you shouldn't worry about this.
Just a little bit of googling will turn up the most important point. It's not generally a problem for healthy humans but can be dangerous in immunocompromised individuals thus a problem in health facilities with people who are sick.
The biggest problem is that its incredibly hard to get rid off so once you have an infection the whole facility might need to completely sterilised.
As with all pathogens, the scary thing isn't necessarily what we're seeing now, it's what we might expect to see in the future. The more C. Auris infections occur, the more opportunity it has to mutate into something scarier. And yeah, confinement and sterilization is a huge expense.
I worked in biotech developing genes. Similar to how yeast naturally produces alcohol or vinegar, yeast can produce other chemicals. Yeast is the most common type of organism being modified via CRISPR for industrial production. Since this is a novel yeast, why does the article not mention the possibility it could have been the result of off target edits or a yeast developed for industrial purposes?
What are the regulations in this area? Seems like a wild west kinda situation right now in biotech. Well and even with regulations, I can't see enforcement being easy or even possible.
The article discusses Candida which is a specific genus of yeast includes species that live with us humans, and can sometimes cause disease, mainly in immunocompromised individuals.
Most of the yeast being engineered with CRISPER is non-pathogenic [1] and is less likely to mutate to this sort of thing.
The mutation the article discusses is more like how bacterias evolve with anti-bacterial drug use. Much like bacterias, pathogenic fungi experience evolutionary pressure from their environment and the drugs we use to control them.
Candida auris was discovered in 2009. CRISPR in 2012. Candida auris itself could not have been the result of any CRISPR editing experiment. Maybe you are suggesting that a particular strain of Candida auris is such a result. This is difficult to refute without an actual genomic analysis. But a much simpler explanation exists: Candida auris is nasty in itself. It does not need genetic engineering to be nasty. It is simply spreading in hospitals among immunocompromised patients because this is what Candida auris does. Per wikipedia [1]:
> Often, candidiasis is acquired in hospitals by patients with weakened immune systems. C. auris can cause invasive candidiasis (fungemia) in which the bloodstream, the central nervous system, and internal organs are infected. It has attracted widespread attention because of its multiple drug resistance. Treatment is also complicated because it is easily misidentified as other Candida species.
Less efficient methods were used for gene editing before CRISPR. The candida strain of yeast is likely not used as base for editing or industrial purposes. Given what we have learned about covid's origins, an analysis of the gene in this yeast is probably needed to confirm its origin and quell any suspicions.
My cursory experience with sourdough baking taught me that yeasts(candida auris is a yeast)are all around us all the time, and that it's all about creating the conditions that lets the desirable ones outcompete the undesirable ones.
Thanks to your comment I just learned from the internet that some people use brewer's yeast and yogurt to make skin masks! (no idea if that would help with candida infections, but I thought it was interesting)
96 comments
[ 3.5 ms ] story [ 151 ms ] threadUnless a novel disease emerges or is manufactured that totally outclasses everything nature came up with in earth's history, we're going to be fine.
But that wasn't when we were at our weakest, not necessarily. Diseases need to spread. When we lived in scattered hunter gatherer groups it was really tough for diseases to spread, and if they couldn't spread, it was difficult for them to persist in a population and evolve. Now the spreading is easy. Furthermore, spreading is easier among certain animal populations because we raise them packed into warehouses and we ship them around the world via truck, train, boat, and plane.
The world is a very different place, so using the past as a model to predict the future is dicey.
"International" trade has surely always existed - we know people far from the sea decorated their bodies with cowrie shells in prehistoric ages. But the scale of contact and interaction has not remained constant.
Arguably, the Middle Ages is when Eurasian society was at its weakest WRT disease.
It's estimated it wiped out 25-60% of the population of Europe over the course of 2 centuries (15-100 million people).
https://en.wikipedia.org/wiki/Plague_of_Justinian
1. As other commenters have pointed out, the ease of spread of any disease is orders of magnitude higher now than it was during cave-man days. With crowded cities, public transit, and air travel, pandemic-level diseases can spread across the world in a matter of days or weeks.
2. Much more importantly, our use of medicines (antibiotics, antivirals, antifungals, etc.) have put extreme selective pressure on pathogens to evolve to become resistant to them. We are, in a sense, selectively breeding pathogens that are both good at infecting humans and resistant to our treatments. That is a focused selective pressure that has never existed before, and may pose the biggest threat to us in the next 50-100 years. For a concrete example, look at this experiment which shows how quickly bacteria can evolve to overcome levels of antibiotics that are orders of magnitude more than we would ever give a human [0].
Yes, there will generally always be some subset of the human population that is resistant to any particular disease, but our measure of success is not "5% of humans will survive the next pandemic, so we're all good, let's it move along nothing to see here." If we start to regularly have drug-resistant pathogens that make hospital stays very dangerous for patients (imagine having a 1/3 or even 1/10 chance of dying at a hospital due to an infection entirely irrelevant to your condition) or just more common COVID-level pandemics, that would be a serious disruption to humanity, significantly increase general mortality rates across the board, and drastically change life as we know it.
[0] https://www.youtube.com/watch?v=w4sLAQvEH-M
I don't think that makes sense when comparing against the threat level of pre-antimicrobial times. It didn't matter that they weren't resistant before we had antimicrobial drugs. Lack of resistence was useless in cave man times.
> As we increase our interactions with animals through hunting, the trading of animal foods, animal husbandry practices, wet markets, and the domestication of animals or exotic pets, the probability of cross-species transmission dramatically increases.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2874076/
Regardless of morals, the more animals we kill, the more pandemics we’re going to have.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9239177/
The truly terrifying thing is that the reason fungi have not been a big threat to humans is that there was not evolutionary pressure for them to thrive in human body temperatures.
Now, due to the warming climate there is immense pressure. As fungi evolve to adapt to the warming climate, they are evolving to be able to infect and kill us.
Climate change was mentioned on "The Last of Us" episode 1, at the start. Aside from fictional references, there are fungi that can grow outside of 70-90F up to 130-150F. I believe COVID and people rushing to the hospital emergency room for everything instead of going to their PMC may have had something to do with this fungus finding purchase to infect more people.
Significant or not? <<many other factors may have contributed>>
<<The most enigmatic aspect of the rise of Candida auris as a human pathogen is that it emerged simultaneously on three continents, >>
I would be interested to know if COVID happened everywhere around the same time relatively speaking, with people self-quarantining while all running to the emergency room of hospitals, might explain the "enigma" above.
> The hypothesis that C. auris broke the mammalian thermal barrier through adaptation to climate change suggests several experimental lines of investigation to obtain evidence for and against it.
Nonetheless, they still cite to earlier papers (multiple!) of theirs to argue that they "predicted" their current speculative conclusion; for example,
> Given the capacity of fungal species to adapt to higher temperatures and the fact that many fungal species that are currently nonpathogenic species are likely to have the necessary virulence attributes by virtue of their survival in soils, we previously hypothesized that climate change would bring new fungal diseases
And in case anybody missed it (as I did, initially), the entire body of this "paper" is under the header, "OPINION/HYPOTHESIS".
What makes you think this is unlikely? Even putting aside that bioengineering is a very real thing, there is historical precedent for terrible novel diseases (e.g. black death, Spanish flu).
I'll also point out that "humanity is totally wiped out" and "we're going to be fine" are not exhaustive. A disease killing 10% of the world's population would not be fine.
If a fungus could have already wiped out entire amphibian species, why didn't it to so before? https://en.wikipedia.org/wiki/Chytridiomycosis
There’s two sequels to the story too, but they’re only available in anthologies afaik
> The fungus can infect the bloodstream and even cause death by invading the blood, heart and brain, the agency said. More than 1 in 3 patients die from such an infection.
Damn
> Do you know what they call alternative medicine that's been proved to work?
> Medicine.
Besides that the article is mostly just attempted character assassination of various people and goes after some of the more fringe elements / treatments in the field.
A huge part of functional medicine is just helping the patient address lifestyle factors - diet, exercise, sleep, stress, and removing negative environmental influences, whether those are a person, a diet issue (particular foods can do a lot of damage), a physical environmental issue such as mold, etc.
The first step that every (decent) functional medicine doctor takes with a new patient is just looking for nutritional deficiencies and other lifestyle factors, and doing tests and asking questions to check for those things. Completely uncontroversial and backed up by science that everyone on earth agrees with. But regular doctors don't even take that basic step for their patients because it takes too long to actually learn about a person, their background, their personality, etc. and actually help them create lifestyle change.
Beyond that, I wish the critics would actually address the more common treatments in functional medicine instead of the fringe stuff. Things like alternative treatments for parasites (blastocystis, various worms, dientamoeba, etc.), candida overgrowth, SIBO, heavy metal poisoning, various autoimmune issues, nutritional deficiencies, hormonal issues, etc.
The modern healthcare system is broken in a hundred ways but instead of having any curiosity about alternative approaches folks like the author of this article just attack the field and the people in it rabidly.
In 1832 most medical doctors were probably kooks by today's standards. They certainly knew very little.
[1] https://en.wikipedia.org/wiki/Allopathic_medicine
HN is still full of pedants. Must get in the habit of saying drug resistant so that when I'm tired, distracted, etc, I don't misspell antifungal.
B. Antibiotic resistance is associated with certain metabolic states, such as excess acidity. Some studies suggest it is reversible if you address this, yet this seems to not be standard practice.
C. I wonder if anyone has tried salt as a treatment. (Probably not.)
You're making a huge leap.
The magnitude of "unwell" here is critical. This particular infection has been killing people who are at end of life -- people in nursing homes, hospice, etc. Maybe the pandemic created more of these people, but it's not the same thing as "long covid" (if that even has a definition).
Folks with these sorts of ME/CFS/Long Covid constellations of symptoms are simply not in the same class as elderly people in nursing homes.
A lot of people got such treatment for covid.
Edit:
To the coward who made a drive by swipe at me then deleted it before I could hit reply:
Look, I'm not the one putting out info that this infection has spread dramatically. The CDC is.
I'm wondering what some of the mechanisms are for spreading it.
We likely don't know what the tipping point is for something like this. You treat enough school kids for parasitic worms in a developing country and general incidence goes down for the entire neighborhood surrounding the school.
First, it doesn't "often" attack anyone -- there have only been several thousand cases, total.
Second, you can't bundle together "was on a ventilator at some point" with "is currently on a vent and in a hospital". Very different, and again, the latter is where this fungus is being seen. People in hospitals, having serious full-time care. These are not "lung issues", they're acute, near-death interventions.
Third, people in the ICU on a vent are at serious risk for everything -- a rare fungus is far down the list, below things like strep, H. inf., S. aureus, E. coli, etc., which are ubiquitous, and all over your body, right now. If you're not worried about those, you shouldn't worry about this.
[1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4056625/#:~:tex...
Candida species are isolated with high frequency from cystic fibrosis patients...
https://academic.oup.com/mmy/article/48/Supplement_1/S114/10....
Granted, not specifically about candida auris, but the pattern stands.
If you are immunocompromised and they stick medical devices into you, this is a good vector for such things to take hold.
This one is rare. Those are not.
And I don't see any relevance whatsoever.
The biggest problem is that its incredibly hard to get rid off so once you have an infection the whole facility might need to completely sterilised.
And we've changed nothing and undone everything.
Good luck getting people to care about 1,400 infections.
[1] https://pubmed.ncbi.nlm.nih.gov/31280424/
I wonder if such an approach could work here.
https://en.wikipedia.org/wiki/El_Mundo_Gira